Copyright @ 2006 American Society for Colposcopy and Cervical Pathology. Unauthorized reproduction of this article is prohibited. Abstracts: Fall 2006 The following abstracts are taken from journals of interest to our readers and are reviewed by Thomas M. Julian (TMJ), Charles J. Dunton (CJD), Richard S. Guido (RSG), and L. Stewart Massad (LSM). Atypical Squamous Cells-cannot exclude HSIL (ASC-H) in Pap TestVDefinitive Categorization of Cytomorphological Spectrum M Chivukula, V Shidham Cytojournal 2006;03:14 The American Society for Colposcopy and Cervical Pathology guidelines for management of atypical squamous cellsYcannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H) is colposcopic examination followed by biopsy. Human papillomavirus (HPV) testing (HPVT) is recommended after a negative biopsy result. More definitive interpretation of ASC-H could prevent discomfort and minimize the cost. The purpose of this study was to evaluate the association of various cytomorphological patterns of ASC-H with various clinical scenarios. We reviewed SurePathTM (TriPath Imaging, Inc., Burlington, NC) cervical smears interpreted as ASC-H in 161 women (mean age, 37 [15Y78] years), over 24 months (2002Y2003). The HPVT (Digene Hybrid Capture(R) II HPV test, Digene Corp., Gaithersburg, MD) was performed in 20% (33/161) of cases, and biopsy results were available in 54 cases (19 with HPVT and 35 without HPVT). The HPVT was positive in 64% (21/33) of cases, and negative in 36% (12/33) of cases. In the follow-up biopsies of 71% (15/21) of cases with positive HPVT, 27% showed HPV changes or cervical intraepithelial neoplasia (CIN) 1, 27% showed CIN 2,3, and 46% were negative for epithelial abnormality. Follow-up biopsies from cases with negative HPVT (33%, 4/12 cases), 8% showed CIN 1 and 25% were negative for any epithelial abnormality. Six cytomorphological patterns of ASC-H correlated with different clinical categories in relation to HPVT and biopsy results. A total of 35% (19/54 ASC-H cases in which biopsy results were available) could be interpreted definitively as HSIL by cytopathology; 11% (6/54) of cases as LSIL, with cyanophilic atypical parakeratotic pattern; and 31% (17/54) of cases as reactive, with HPV status. The interpretation had to be continued as ASC-H in 22% (12/54) of cases. The ASC-H demonstrated a spectrum of cytomorphological patterns. Some of these patterns in liquid-based cervical smears may be more specifically interpreted as LSIL, HSIL, or benign, if HPV status is known. Comment: What this study shows is that ASC-H is a subjective reading, like most cytology of the cervix. The problem with a study like this is no clinician will be freed of the burden of further investigation when a pathologist rereads and, therefore, reinterprets a smear. The ASC-H, for all practical purposes, should be eliminated and included with LSIL or a new Bcolposcopy indicated^ reading. Do you think that will ever happen? (TMJ) Performance of Pap Smear and Human Papilloma Virus Testing in the Follow-Up of Women With Cervical Intraepithelial Neoplasia Grade 1 Managed Conservatively AL Santos, SF Derchain, LO Sarian, MR Martins, SS Morais, KJ Syrjanen Acta Obstet Gynecol Scand 2006;85:444Y50 Conservative management (follow-up) of cervical intraepithelial neoplasia (CIN) 1 is acceptable, but evidence on the performance of follow-up tools, such as Pap smear and human papillomavirus (HPV) test, is still needed. A cohort of 78 women with histologically confirmed CIN 1, referred because of atypical squamous cell or low-grade squamous intraepithelial lesion in their Pap smear, was enrolled between August 2000 and September 2002 and was prospectively followed-up at 6 and 12 months until September 2003. Follow-up examinations included Pap test and Hybrid Capture II (HCII) with high-risk HPV, colposcopy, and cervical biopsies in patients with persistent abnormalities. Odds ratios and performance indicators (with 95% CI) were calculated for HPV and Pap test results Ó 2006, American Society for Colposcopy and Cervical Pathology Journal of Lower Genital Tract Disease, Volume 10, Issue 4, 2006, 272Y275